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Scott Mewhorter receives MinnesotaCare. He says he wants to keep working, but needs help with his health insurance. Mewhorter says MinnesotaCare is the only option right now. (MPR Photo/Tom Scheck)

As part of his plan to balance the state's budget, Gov. Tim Pawlenty has called for dropping at least 27,000 people from the MinnesotaCare program. MinnesotaCare was set up several years ago as a subsidized health insurance program for the working poor. But the people who created the program say it was a bipartisan effort to reduce the cost of health care. They say Pawlenty's plan would increase the number of people without health insurance and possibly increase the number of people on welfare in Minnesota.

St. Paul, Minn. —
Scott Mewhorter, 29, is the perfect example of why some in the health care industry say MinnesotaCare works. Three years ago, he was hospitalized and first diagnosed with schizophrenia -- and he ended up losing his job. Mewhorter is now working part-time, even though he could apply for disability benefits through Social Security and not work at all.

"It's a self-respect thing," Mewhorter said. "It's a better thing to work or go to school than collect Social Security, especially when the meds make me normal. So there's no reason why I can't go out in the workforce."

Mewhorter spent several months in the hospital when he was first diagnosed. After he was released, he enrolled in MinnesotaCare. The program pays for several doctor visits, and the bulk of his monthly medication costs, which amount to $550.

Because his bills exceed MinnesotaCare's $5,000 limit, Mewhorter says he pays another $1,000 out of his own pocket. He says he would probably file for disability and quit working if MinnesotaCare wasn't available.

"I need to have my meds," Mewhorter said. "Without MinnesotaCare, it's going to be much more difficult for me to get my meds. In the end, I'm going to be paying for it somehow."

Supporters of MinnesotaCare say taxpayers and people with insurance will end up paying for people like Mewhorter if they're cut from the program.

Republican Arne Carlson, who was governor in 1992 when he and a bipartisan group of lawmakers created MinnesotaCare, says the program was designed to provide health coverage to people who had jobs, but didn't make enough money to afford coverage in the private marketplace.

He says the high cost of health insurance, the rising rate of people without insurance, and the effort to get more welfare recipients working were the main reasons he backed the program. He says those trends in the early '90s resemble the current health care system.

"It's almost incomprehensible that we would get back into a scenario where a budget deficit compels us to hurt those in greatest need, the working poor in our society."

- Paul Ogren, former DFL lawmaker

"We designed the program to meet the legitimate needs of families that are working," Carlson said. "Families that are poor, families that are in need, making sure that they and their children have access to good health care. That's what it's about."

Both Carlson and former DFL Rep. Paul Ogren say Pawlenty's proposed cuts are shortsighted. Ogren, who authored the original MinnesotaCare bill in the House, says 150,000 people are currently enrolled in MinnesotaCare. He says cutting the working poor from the program will only increase the number of people without insurance.

"It's almost incomprehensible that we would get back into a scenario where a budget deficit compels us to hurt those in greatest need -- the working poor in our society," Ogren said.

Ogren and others say cutting people off MinnesotaCare means they are less likely to get preventative care. That means they will only seek care when they're seriously ill. That worries hospital officials, who say the uninsured will end up in emergency rooms, needing the most expensive form of care.

Former Republican Sen. Duane Benson also worked on the original MinnesotaCare legislation. He says when the uninsured can't or won't pay their bills, hospitals will have to charge more for those who can. Benson says that means the cost of health care will go up for everyone. He says one of the goals of MinnesotaCare was to hold health care costs down.

"In a bizarre way, everybody is covered currently. We just pay for it in the weirdest ways," says Benson. "So this was a way to be more upfront, more transparent, to show how we pay for this."

Benson says he understands that a budget deficit has put Gov. Pawlenty in a tough position, but says cutting back on MinnesotaCare is not the best solution.

Pawlenty says he's proposing the changes because the state can't afford to pay rising health care costs. He says a safety net will still be in place for those who need it, but only after they spend a large part of their income on their own health care. Pawlenty says the Legislature needs to dramatically change how the state pays for health care.

"The system is fundamentally broken," Pawlenty says. "In the near term, we need to manage that by maintaining eligibility and payments in a way that we can afford. In the long run we're going to have to change the system."

But the original authors of MinnesotaCare say it was designed to change the system. They say cutting back on the program now is a step backwards.